AMSTERDAM STATEMENT TO WTO MEMBER STATES ON ACCESS TO MEDICINE

This statement was developed at the Increasing Access to
Essential Drugs in a Globalised Economy Working Towards Solutions
conference, which was organized by Health Action International,
Médecins Sans Frontières, and Consumer Project on Technology, and
took place in Amsterdam, the Netherlands, November 25-26, 1999.

Background:

1.3 billion people in the world live on less than US$1 per
day

20% of the world's population consumes 80% of the world's
resources

Every 3 seconds a child dies of diseases of poverty

17 million deaths per year are due to infectious disease

Currently 33 million people live with HIV, 7-8 million with
active TB

More than 90% of all death and suffering from infectious
diseases occurs in the developing world

20% of the world's population uses 80% of the world-wide
production of medicines

0.2% of pharmaceutical research is devoted to acute
respiratory infections, TB, diarrhoea, while 18% of deaths are
attributable to these diseases.

In the developing world, a lucrative or "viable" market for
lifesaving drugs simply does not exist. But clearly what does
exist is need. The market has failed both to provide equitably
priced medicines and to ensure research and development for
infectious disease. This lack of affordable medicines and
research and development for neglected diseases is causing
avoidable human suffering. Market forces alone will not address
this need: political action is demanded.

At the Amsterdam conference, participants called for health to be
made a priority at the WTO Seattle negotiations and demanded a
balance between the rights of patent holders and the rights of
citizens in intellectual property rights regulations. These
views were shared by representatives of UNDP, the WHO, the WTO,
members of the Dutch and Thai governments, and NGOs which
attended the Amsterdam conference. The meeting brought together
350 participants from 50 developing and developed countries, from
both the private and public sectors.

Organisers of the Amsterdam meeting call for:

The WTO to create a Standing Working Group on Access to Medicines

This working group would work with the Council for TRIPS and
other WTO bodies to review a number of issues concerning
intellectual property rules, as they relate to access to
medicines.

The Standing Working Group on Access to Medicines should work
within the WTO to consider the impact of trade policies on people in
developing and least developed countries, and provide a public
health framework for the interpretation of key features of WTO
agreements. The WHO and other relevant international
organizations should play an active role to support the
activities of the working group. The TRIPS Agreement is meant to
protect intellectual property rights while also protecting and
advancing various public interest objectives. This balance must
be addressed to ensure that people have access to essential and
life-saving medicines. As countries implement the TRIPS
agreements the WTO will be asked to resolve disputes in areas
that are subject to numerous different interpretations. The WTO
is also constantly evaluating proposals for changing the TRIPS
Agreement. The Standing Working Group on Access to Medicines
would provide a forum for considering public health issues and
rights of people in both of these processes.

The proposed working group on access to medicines would examine a
number of important issues in the implementation of the existing
TRIPS Agreement, such as:

Compulsory licensing of patents, as permitted under Article
31 of the TRIPS Agreement. The working group should look for
ways to best operationalise this article;

Allowing for exceptions to patent rights (under Article 30
of TRIPS) for production of medicines for export markets, when
the medicine is exported to a country with a compulsory license.
This would ensure that countries with small domestic markets can
benefit from compulsory licensing;

Allowing for exceptions to patent rights (under Article 30
of TRIPS) for medical research, so that patents are not used to
stop research and hamper the introduction of generic medicines;

Examining new paradigms for intellectual property rights and
health care, including "burden sharing" approaches for R&D that
permit countries to consider a wider range of policy instruments
to promote R&D;

Assessing the practical burdens on poor countries of
administrating patent systems and resolving disputes over rights.

National governments need to develop mechanisms to ensure funding
for R&D for neglected diseases

New and innovative approaches to stimulating research in
essential medicines need to be devised, including:

Increased public and donor funding of health care research:

Compulsory research obligations, such as requirements that
companies reinvest a percentage of pharmaceutical sales into R&D,
either directly or through public or private sector R&D programs;

Development of a "Neglected Disease Act" that could be used
to stimulate private investment for communicable disease vaccines
and medicines.